Cardiovascular aspects and the state of vegetative balance in patients with arterial hypertension associated with dyslipidemia

Abstract

Objective. The aim of this study was to investigate the effect of dyslipidemia on cerebral and intra-cardiac hemodynamics, heart and blood vessels remodeling and the state of vegetative balance in patients with hypertension. Materials and Methods. 100 patients with stage II arterial hypertension (AH) were examined. Depending on the total cholesterol (TCh) level, all patients were divided into two groups: the group I included 69 patients with AH and hypercholesterolemia (HCE), the group II - 31 patients without HCE. All patients were subjected to the evaluation of DMA Р , echocardiography, duplex pulsed-wave Doppler extracranial vessels, heart rate variability (HRV) according to the Holter monitoring of ECG. Results . TCh levels over 5 mmol/L were observed in 69% of patients with AH. Hypertensive patients with HCE and patients with normal level of TCh did not differ from each other in all indicators of office blood pressure, LV systolic and diastolic function parameters and pressure in LA. Patients with AH associated with HCE had a significantly larger LA size in systole by 10.8% and diastole by 6.9%, and the thickness of IVS in systole by 13.33%. There was a significant decrease in the maximum linear velocity of blood flow in both CCAs by 11%, in both VAs by 16%, in BA by 12.9%, as well as a reliable decrease in the vascular reactivity index of sensitivity to hypercapnia in BA by 15.1% in the group I. Patients of both groups did not differ in all time and spectral indices of HRV, however, hypertensive patients with HCE had increased activity of the sympathetic nervous system, as demonstrated by the LF/HF index of more than 2 CU. Conclusions . The presence of hypercholesterolemia in patients with AH does not affect significantly the level of blood pressure, but affects the parameters of cardiac remodeling, and also has an effect on the cerebral blood flow and the state of vegetative balance.